Coronary transfer in the arterial switch operation: the modified closed technique

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Congenital Heart Disease

Background:

• Transposition of great arteries (TGA) is a critical congenital heart defect requiring surgical intervention.
• The arterial switch operation (ASO) is the gold standard surgical repair for TGA.
• Conventional "open" coronary transfer techniques are widely used but present challenges.

Purpose of the Study:

• To describe a modified "closed" technique for coronary transfer during the arterial switch operation for TGA.
• To highlight the advantages of this modified technique in achieving accurate coronary artery placement and reducing surgical complications.

Main Methods:

• A modified "closed" technique for coronary artery transfer during ASO is detailed.
• Emphasis is placed on accurate coronary artery implantation considering aortic distension.
• The use of anterior interrupted sutures to mitigate purse-string effects is described.

Main Results:

• The modified "closed" technique allows for more precise coronary artery placement.
• Anterior interrupted sutures help reduce purse-string complications.
• This approach offers potential advantages for improved surgical results in TGA repair.

Conclusions:

• The modified "closed" coronary transfer technique represents a valuable refinement for the arterial switch operation in TGA.
• This technique may enhance surgical outcomes and patient recovery.